Women's Heart Attack Symptoms Often Missed: Fatigue, Dizziness Signal Danger

Cardiovascular disease kills one in three people in Chile each year, yet the way a heart attack announces itself remains stubbornly misunderstood—especially when the person experiencing it is a woman. Patricia Donoso, who directs the nursing program at Universidad Andrés Bello's Viña del Mar campus, has spent years watching this gap between what medicine teaches and what actually happens in a patient's body. The problem, she explains, is not that women's hearts fail differently. It's that the entire architecture of medical training was built on the wrong blueprint.

When a man has a heart attack, the textbooks are clear: crushing chest pain that radiates down the left arm or into the jaw. Doctors know what to look for. Women, however, often experience something far more diffuse and harder to name. Fatigue that feels like it belongs to a long week at work. Dizziness that might be dismissed as low blood pressure. Nausea that a patient herself might attribute to something she ate. Shortness of breath. Palpitations. In some cases, a woman can have a heart attack with almost no chest pain at all—just a vague sense that something is profoundly wrong. This ambiguity costs lives.

The root of the problem runs deeper than individual oversight. Medical schools across Chile, like institutions worldwide, have historically conducted their foundational research on male patients. The protocols, the warning signs, the diagnostic criteria—all of it was calibrated to recognize a male heart attack. When a woman arrives at an emergency room describing fatigue and nausea, a doctor trained on this male-centered evidence may think digestive trouble, or stress, or anxiety. By the time the actual diagnosis arrives, hours have been lost. And in cardiology, hours matter.

Donoso is direct about what needs to change. "The model of a heart attack that we teach in health schools was built on evidence from studies done predominantly in men," she said. "That bias has real consequences." Women who have heart attacks already face worse outcomes than men—their attacks tend to be more severe, their survival rates lower. Part of that disparity traces directly back to delayed recognition. A woman might wait longer to seek help because her symptoms don't match the story she's been told about what a heart attack looks like. Or she might seek help and be sent home because her presentation doesn't fit the familiar pattern.

The solution, Donoso emphasizes, is not complicated but it is urgent. Everyone—not just doctors, but the public—needs to know that a heart attack in a woman might announce itself as exhaustion, as dizziness, as a tightness in the chest that doesn't radiate anywhere, as nausea, even as a brief loss of consciousness. The specificity matters because recognition saves lives. Getting to an emergency room quickly, with the right diagnosis in mind, can mean the difference between recovery and death, between a functioning heart and permanent damage.

This is not a problem that will solve itself through individual awareness alone. Medical training protocols need to shift. Diagnostic guidelines need updating. But the immediate work belongs to everyone: knowing the atypical signs, trusting your body when something feels wrong, and acting fast. In cardiology, there is no such thing as being too cautious. The cost of missing a heart attack in a woman is measured not in embarrassment or inconvenience, but in lives.